Prognosis
Improved care has resulted in a good prognosis and normal life expectancy. The introduction of the newborn screening has significantly reduced neonatal morbidity and mortality in classical congenital adrenal hyperplasia (CAH).[30] However, adrenal crisis at all ages remains a major cause of mortality for these patients.[31]
Classical CAH requires lifelong treatment whereas non-classical CAH requires treatment only in select symptomatic patients.
Psychosocial considerations
Quality of life
Data are primarily available for classical CAH. Results in children are conflicting. Treatment with dexamethasone and obesity have been linked to poor quality of life in adults.
Psychological and neurocognitive effects
Although results are somewhat inconsistent, higher prevalence of anxiety and depression have been reported. Higher odds of developmental delay have been also observed in youth with classical disease.
Sexuality and gender development
Rates of bisexual and homosexual orientation are increased in women with 46,XX CAH but still limited to a minority.[14] One systematic review and meta-analysis found that gender identity disorder was low in women with CAH.[32]
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